TABLE 4-1 Selected Performance Measure Sets Used by One or More Government Health Programs

 

CAHPS

DQIP

ESRD CPMs

HEDIS

MDS

CMS National Priorities

OASIS

Setting

Health Plans, FFS

Outpatient, hospital

ESRD facilities

Health plans

LTC facilities

Out-patient, hospital

Home Care

Types of Measures

Outcomes

Process

Outcome

Process, outcome, structure

Process, outcome

Process, outcome

Outcome

Medicare

X

X

X

X

X

X

X

Medicaid

X

X

 

X

X

 

X

SCHIP

X

X

 

X

 

DOD TRICARE

X

X

 

X

 

VHA

X

X

 

IHS

 

X

 

NOTE: CAHPS = Consumer Assessment of Health Plans; CMS = Centers for Medicare and Medicaid Services; DQIP = Diabetes Quality Improvement Project; ESRD CPM = End stage renal disease, clinical performance measure; FFS= Fee for service; HEDIS = Health Plan Employer Data and Information Set; IHS = Indian Health Service; LTC=Long term care; MDS = Minimum data set; OASIS = Outcome Assessment and Information Set; SCHIP = State Children’s Health Insurance Program; VHA = Veterans Health Administration.



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